Proactive Wellness Group

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

PROACTIVE WELLNESS GROUP

Practice address

805 W Jefferson St Ste a
Shorewood, IL 60404-7379

Phone

(815) 725-8660

NPI assigned

Jul 18, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Daniel Spaccapaniccia, DCNPI 1497443964

Title

Owner/Chiropractor

Phone

(815) 725-8660

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Spaccapaniccia, DC

  • Chiropractor
  • Shorewood, IL
  • NPI 1497443964
  Medicare reassignment Care Compare group NPD Authorized official
• Gabriel Griffith Ellis, DC

  • Chiropractor
  • Shorewood, IL
  • NPI 1821316951
  Medicare reassignment Care Compare group NPD
• Amanda J Lemay, FNP-C

  • Family Nurse Practitioner
  • Joliet, IL
  • NPI 1790390797
  Medicare reassignment NPD
• Julia Malosh, DC

  • Chiropractor
  • Shorewood, IL
  • NPI 1285591800
  NPD (past)
• Nicholas James Szopinski, D.C.

  • Chiropractor
  • Shorewood, IL
  • NPI 1316303779
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1275213902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W JEFFERSON ST STE A",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604047379",
            "telephone_number": "815-725-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W JEFFERSON ST STE A",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604047379",
            "telephone_number": "815-725-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "SPACCAPANICCIA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "815-725-8660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Margaret Poe, OTR/L
• Melissa Polchlopek, LMT
• Rachel Pollock
• Isabella Prado
• Megan Price
• John A. Propati, O.D.
• Jessica Purvis
• Kathleen Anne Purvis, PHARM D.
• Lauren Relyea
• Lauren Alexandra Rendak

• Nurse Practitioner in Shorewood, IL
• Providers in Shorewood, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.